If you lose your ability to make a living because of injury or illness, you may need to file a disability insurance claim. Disability insurance pays a part of your income if you’re unable to work because of your health.
If your claim is disputed or denied, you can hire a disability insurance claim lawyer to make sure you receive a fair percentage of your prior income.
Before you can receive any benefits, however, you’ll have to prove to the insurance carrier that you’re disabled in a way that prevents you from doing your job.
Understanding Disability Insurance
After succumbing to an injury or illness, you may not be capable of performing your job or making the same amount of money you used to. Disability insurance replaces a portion of your income each month. Instead of being paid bi-weekly for a job, you get a fixed payment each month.
Once the injury occurs, you should file a disability claim as soon as possible. There could be a deadline for the claim and it could take some time for your claim to be processed. If you want to ensure you receive benefits in a timely manner, you may want to consult with a lawyer.
How Do You Get Disability Insurance?
You may qualify for disability insurance if your employer offers coverage at work. Many employers will pay the premium themselves. In some states, employers are required to offer short-term disability benefits.
If your employer doesn’t pay for disability coverage, you may be able to add it as a voluntary benefit to your existing workplace insurance at a group rate.
You can also buy a private disability insurance plan. You can purchase these plans through major providers like Guardian, Northwestern Mutual, or others, which may be available as short-term or long-term options.
Types Of Disability Insurance
The two main types of disability insurance are short-term and long-term coverage through private or employer-based plans. You may also qualify for state disability insurance if you live in certain states, as well as federal disability if you meet specific requirements.
It’s important to note that policies vary, especially in how “disabled” is defined. Some plans may only pay if you can’t work any job you’re qualified for, while others only pay if you can’t perform your specific occupation. It’s important to make sure you understand your policy.
Short-Term Disability Insurance
Short-term disability insurance may pay out a claim for up to two years, but could only last a few months as well. This disability insurance replaces 60 percent to 70 percent of your base salary. Your benefits may also be capped, or limited, after you receive a certain amount of money. You may have to wait up to two weeks to receive benefits after filing a claim.
Long-Term Disability Insurance
Long-term disability insurance replaces 40 percent to 60 percent of your income, but the benefits won’t end until you’re no longer disabled. Otherwise, the benefits will end after a fixed number of years or until you reach an age of retirement. Because this is a major payout, you could wait around 90 days before you receive benefits.
State Disability Insurance
Some states, like California and New York, have certain laws that factor into how you receive disability benefits. Other states, like Hawaii, provide state-funded benefits or mandate employers to provide disability coverage.
States that provide coverage or require employers to offer disability include:
- New Jersey
- New York
- Rhode Island
To learn more about this option, contact your state’s insurance department or reach out to a lawyer or insurance professional.
Federal Social Security Disability Insurance (SSDI)
Social Security Disability Insurance (SSDI) is only available to people who have earned a set amount of Social Security work credits within a certain timeframe. These work credits help the government determine if you’ve been in the workforce long enough to receive benefits.
You may be eligible for SSDI if your disability prevents you from performing any sort of work and you worked long enough to contribute enough money towards Social Security.
Why Your Disability Insurance Claim May Have Been Denied
Regardless of the type of disability insurance plan you have, some insurance adjusters may deny your claim. Insurance companies have a duty to pay out policyholders if you submit a valid claim, but your claim could be denied for a variety of reasons.
Your Disability Claim Can’t Be Proven
Perhaps the most important aspect of filing a disability claim is the ability to prove you’re disabled. You need more proof than a simple description of your injury or illness.
To avoid a disability claim denial, be sure to submit the following information:
- medical records
- doctor reports or notes
- pharmacy records
- other documentation that supports your injury or illness
Your Disability Is Excluded
Your disability claim may also be denied if you have a certain condition that’s excluded in the policy. Even though you may be disabled, how disability is defined in your policy matters.
If your claim is denied and your insurance company reports that your disability is excluded, you may want to hire a lawyer to review your case. If you believe your disability or medical condition should be covered under your policy, a lawyer could be a major asset.
Your Disability Was Self-Inflicted
Although disability policies vary, the standard is that if your disability was self-inflicted, then you won’t be eligible and your claim will likely be denied. If your injury or illness occurred through no fault of your own, then your claim should not be denied if submitted properly.
Your Disability Is A Pre-Existing Condition
Some insurance companies may deny a claim because they cite your disability is a pre-existing condition, which may be excluded from your policy.
If your claim was denied for this reason, you will likely have to go through a lengthy and complicated administrative appeals process. You’re likely best served by a lawyer if your claim was denied due to a pre-existing medical condition.
You Misrepresented Yourself
If you were untruthful about your health or hobbies before the injury occured, then your insurance company may deny your claim.
Some insurance companies may use whatever they can to avoid paying a claim. If your health was compromised in some way before the accident or onset of illness, but you failed to include it in your insurance application, you could get denied.
Not Enough Medical Evidence
Even if you feel you have enough medical documentation to prove your disability, some insurance companies may deny your claim by saying you didn’t submit enough medical evidence.
Insurance companies can be strict when it comes to medical documentation, but if you believe you submitted an adequate amount, a disability lawyer could help your claim.
How To Choose A Disability Insurance Lawyer
If you were injured or have fallen ill and can no longer perform your job, then you may be able to file a disability claim with your insurance and start receiving benefits. However, filing insurance claims can be complicated and you could run into trouble.
Once you experience any trouble, don’t hesitate in reaching out to a qualified lawyer. To choose an effective lawyer to help ensure you receive benefits, consider the following.
Comfort And Communication
When you work with a lawyer, you want to be comfortable with them. You’ll communicate personal information they can use to help your claim, so you’ll want to hire a lawyer who makes you feel comfortable. To serve you best in your disability claim, a lawyer will need to gather a lot of personal details.
Appropriate Credentials And Experience
You’ll want to choose a lawyer who is qualified and has years of experience in insurance claim disputes or disability cases. You can ask about credentials and experience when you reach out, or you can go over their website to learn about who they are and what they’ve done.
Before you select a lawyer to help with your disability claim, it helps to understand the cost. A lawyer may charge a flat fee or work by the hour, or they could be contingency-based where they’re only paid if they win your case. Ask if they can estimate the cost so you understand what you’re in for.
You’ll want to hire a lawyer who is familiar with your area. Some states have local laws that factor into disability insurance, so you’ll want to work with a lawyer who understands how these laws could play a role in your claim.
Top-Rated Disability Insurance Claims Lawyers Serving The U.S.
Florin|Roebig represents people with disability insurance claim disputes in multiple states. Although you should be able to count on your insurance to honor the agreement in your policy, some insurance companies may do all they can to avoid paying out your claim.
At Florin|Roebig, we have years of experience resolving disability claim disputes. We operate offices in numerous states and could be the right fit to handle your claim.
Reach Out For A Free Case Evaluation
Filing a disability claim is stressful enough. It can be a huge help to hire a lawyer to resolve any disputes or claim denials. But if you’re unsure if hiring a lawyer is really necessary, we offer a free case evaluation to help you decide.
To learn more about disability insurance claims, or to start your free case evaluation, please contact the offices of Florin|Roebig today.